Individual provider Active NPI

Samuel H Bairu, M.D.

  • Infectious Disease Physician
  • Sun City West, AZ
National Provider Identifier
1083828750
Registry record updated Oct 2, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
45091 Issued in AZ
Practice address
14502 W Meeker Blvd
Physician Is a Hosptialist Only
Sun City West, AZ 85375-5282
Phone
(206) 290-2756
Fax
(623) 974-9434
NPI assigned
May 10, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 2, 2014

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X 203365 LA
Infectious Disease Physician 207RI0200X 45091 AZ Primary

Addresses

Primary practice location

14502 W Meeker Blvd
Physician Is a Hosptialist Only
Sun City West, AZ 85375-5282

Mailing address

4410 W Union Hills Dr
# 7, PMB # 280
Glendale, AZ 85308-1660
Phone (623) 974-6611

Other identifiers 1

IdentifierTypeStateIssuer
664569MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20120306000929 AZ Practitioner - Infectious Disease 1254590581 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious Disease
Education
Other, 1992
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

14502 W Meeker Blvd
Sun City, AZ 85375-5282
Phone (623) 974-6611

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
60.06 of 100Reported as individual
Quality
80.9
Improvement activities
0
Cost
75.66

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
203365LAMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Red Sea Infectious Diseases, LLC Infectious Disease CurrentSince Nov 1, 2011 Accepting new patients

Locations

4410 W Union Hills Dr
Ste 7
Glendale, AZ 85308
Phone (203) 632-6595

10401 W Thunderbird Blvd
Sun City, AZ 85351
Phone (623) 815-7690

14502 W Meeker Blvd
#A
Sun City West, AZ 85375
Phone (206) 290-2756

14502 W Meeker Blvd
Sun City West, AZ 85375
Phone (623) 214-4000

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 3

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1178755200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412208000000",
    "number": "1083828750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4410 W UNION HILLS DR",
            "address_2": "# 7, PMB # 280",
            "city": "GLENDALE",
            "state": "AZ",
            "postal_code": "853081660",
            "telephone_number": "623-974-6611",
            "fax_number": "623-974-9434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14502 W MEEKER BLVD",
            "address_2": "PHYSICIAN IS A HOSPTIALIST ONLY",
            "city": "SUN CITY WEST",
            "state": "AZ",
            "postal_code": "853755282",
            "telephone_number": "206-290-2756",
            "fax_number": "623-974-9434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BAIRU",
        "first_name": "SAMUEL",
        "middle_name": "H",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-05-10",
        "last_updated": "2014-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "LA",
            "license": "203365",
            "primary": false
        },
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "AZ",
            "license": "45091",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "664569",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sun City West, AZ

Sources for this page

Verify at the official NPI Registry.